Provider Demographics
NPI:1588709760
Name:RAY, COURTNEY WILLIAM (LCSW C)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:WILLIAM
Last Name:RAY
Suffix:
Gender:M
Credentials:LCSW C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4500 GROSS MILL RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2519
Mailing Address - Country:US
Mailing Address - Phone:410-374-4021
Mailing Address - Fax:
Practice Address - Street 1:10784 HICKORY RIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3646
Practice Address - Country:US
Practice Address - Phone:410-992-7288
Practice Address - Fax:410-997-2880
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11545104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
266716000OtherMAGELLAN BEHAVIORAL HEALT
MD275253OtherMAMSI OPTIMUM CHOICE MDIP
332149OtherMANAGED HEALTH NETWORK
7644295OtherAETNA US HEALTHCARE
226613OtherKAISER PERMANENTE
486959300OtherDIVISION OF FEDERAL EMPLO
MD61657401OtherCAREFIRST BCBS
PVPB149968OtherAMERICANPSYCH SYSTEMS
001498578002OtherUNITED BEHAVIORAL HEALTH
163543OtherVALUE OPTIONS
9255119OtherPRIVATE HEALTHCARE SYSTEM
MDH1240011OtherCAREFIRST BLUECHOICE
332149OtherMANAGED HEALTH NETWORK